Krylova Y, Polyakova V, Kvetnoy I, Kogan I, Dzhemlikhanova L, Niauri D, Gzgzyan A, Ailamazyan E
a Department of Pathomorphology.
b Department of Assisted Reproduction Technologies , FSBI D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology , Saint-Petersburg , Russia , and.
Gynecol Endocrinol. 2016 Oct;32(sup2):33-36. doi: 10.1080/09513590.2016.1232576.
Abstracts Background: Implantation failure of in vitro fertilization (IVF) cycles is recognized as one of key problems in contemporary reproductive medicine. Implantation itself is a multifactorial process and one can hardly expect to find a single criterion for the endometrium receptivity. Endometrium biopsy still remains the most applicable technique to diagnose abnormalities causing decrease or complete loss of endometrial receptivity.
We have studied 95 endometrial biopsy samples from 45 patient with I/II stage endometriosis and 40 controls from October 2014 to December 2015. Immunohistochemical analysis of key biological molecules participating in implant window formation (LIF, ER, PR, integrin, TGF-β1 and VEGF) was done to assess their predicting value for endometrial receptivity troubles.
The discriminant analysis demonstrated that highest information capacity was characteristic for LIF expression percent area, integrin αVβ3 both percent area and optic density in endometrial stroma and glands and finally TGFβ1 and VEGF-А percent area expression in endometrial stroma. The model test done on a checking group showed 89.1% correct discrimination. Cross-checking in a teaching group showed a bit lower but still high correct answer percentage (88.8%). A decision-making classification tree was worked out.
The produced model is sufficient for predicting IVF treatment failure and allows producing reasonable treatment tactics as well as encourages IVF treatment effectiveness improvement in patients with endometriosis.
摘要 背景：体外受精（IVF）周期的着床失败被认为是当代生殖医学中的关键问题之一。着床本身是一个多因素过程，很难期望找到单一的子宫内膜容受性标准。子宫内膜活检仍然是诊断导致子宫内膜容受性降低或完全丧失的异常情况最适用的技术。
我们在2014年10月至2015年12月期间研究了45例I/II期子宫内膜异位症患者的95份子宫内膜活检样本以及40例对照样本。对参与着床窗形成的关键生物分子（LIF、ER、PR、整合素、TGF-β1和VEGF）进行免疫组织化学分析，以评估它们对子宫内膜容受性问题的预测价值。
判别分析表明，最高信息容量的特征在于LIF表达面积百分比、整合素αVβ3在子宫内膜基质和腺体中的面积百分比和光密度，以及最终TGFβ1和VEGF-А在子宫内膜基质中的面积百分比表达。在一个检查组上进行的模型测试显示正确判别率为89.1%。在一个教学组中进行交叉检验显示正确答案百分比略低但仍然很高（88.8%）。制定了一个决策分类树。
所建立的模型足以预测IVF治疗失败，并有助于制定合理的治疗策略，同时促进子宫内膜异位症患者IVF治疗效果的提高。
